What does a J-pouch require for management after construction?

• A. A temporary ileostomy
• B. A permanent ileostomy
• C. No ostomy is needed
• D. A colostomy is required

Answer: (A)

A J-pouch is protected after it's formed by diverting stool away from the new pouch-anal connection. This is typically done with a temporary ileostomy. The diversion gives the ileal reservoir time to heal and helps prevent leaks at the anastomosis, reducing the risk of pelvic infection and pouch failure. The ileostomy is usually in place for several weeks to a few months and is reversed once healing is verified.

Permanent ileostomy would defeat the purpose of creating the J-pouch, and no ostomy would leave the new pouch susceptible to leak during the critical healing period. A colostomy isn’t used because the reservoir is built from ileum, not colon.